When faced with intense criticism for her agency's approval of the powerful narcotic painkiller Zohydro, U.S. Food and Drug Administration Commissioner Margaret Hamburg turned to a sobering statistic: 100 million Americans are suffering from severe chronic pain.

The 100 million figure has become a staple in the ongoing debate over the use of narcotic painkillers. It is cited in news stories, by medical organizations and by drug companies seeking approval for new opioid therapies. When Hamburg spoke in April at a prescription drug conference, she noted it means debilitating pain affects more people than heart disease, cancer and diabetes combined.

But that number is exaggerated and misleading, according to pain specialists familiar with how it was derived.

A Journal Sentinel/MedPage Today investigation found that nine of the 19 experts on the IOM panel that produced that report had connections to companies that manufacture narcotic painkillers at the time or in the 3 years prior to their work on the report.

Some were officers or board members of groups that received opioid company funding, others were drug-company consultants or were paid for educational programs funded by companies that make pain drugs.

In addition, panel chairman Philip Pizzo, MD, was dean of the medical school at Stanford University when he chaired the panel, a school, which received educational grants and research funding from companies that make pain treatments.

Yet none of those financial links were disclosed in 2011 when the IOM issued its 364-page report.

That runs counter to the institute's own recommendations to the medical world, which say disclosure of conflicts of interest are "essential."

Catherine DeAngelis, MD, MPH, an IOM member and the former editor of JAMA, took it one step further saying the pain organization board members and officers should have excluded themselves from serving on the panel.

"It's a conflict," she said.

The institute's report devotes only a few pages to opioids, but it warns against efforts to restrict their use.

Indeed, six of the IOM panel members have been officers or board members of advocacy groups that were named in a 2012 U.S. Senate Committee on Finance investigation into the links. A seventh panel member co-founded another organization that is the subject of a separate investigation launched in February by two U.S. senators.

In that case, the group collected as much as $35,000 each from various drug companies and arranged private meetings at expensive hotels that were attended by drug executives, FDA officials and academics who discussed developing new pain treatments, the Journal Sentineland MedPage Today reported last October.

But there has been little scrutiny of the 100 million figure -- one that is the equivalent of 40 percent of the nation's adult population. In recent months, it has been criticized as misleading by a researcher on whose study it was based and another who served as a reviewer of the report.

Special interests are deeply ingrained into the way and acts of the FDA and all others decisions' making agencies.

Approval of new drugs is fueled by blind profit making big pharma companies, which basically bribe doctors and the government to flood the market with what in many cases are just band-aid drugs, not treatments and certainly not cures.

Why would it be different for ME/CFS and the IOM?

Well maybe in our case we have the "advantage"/disadvantage of a lack of a single universal biomarker, the holy grail of old school medicine.

If our few real experts on the IOM panel will stand united and defend what we know to be true and categorically refuse to use any GIGO (garbage in garbage out) study into account for their final decision, maybe we will have an acceptable new definition, but then again science is not done via miracles and a broken system is hardly ever a good system, even less for very ill patients like PWME.

Thank you @Nielk for starting this thread, I'm sure advocates like Jeannette Burmeister are aware of it.